Posts For: July 25, 2009

President Obama’s health-care reform appears to be in increasing trouble. The costs, as scored by the Congressional Budget Office, would be horrendous, public support is collapsing, and Congressional Democrats are at each other’s throats over the issue. It appears increasingly unlikely that either house will hold a vote before the August recess, and that recess is likely to be a time when members of Congress will get an earful from the home folks telling them they hate the whole idea.

Congressional Republicans should probably follow Woodrow Wilson’s admirable advice to “never murder a man who is committing suicide.” But once ObamaCare implodes, the loyal opposition will likely be ready with an alternative. I don’t mean an alternative overarching, comprehensive, fix-everything-instantly plan that’s impossible for the layman to get a handle on (that’s what’s wrong with ObamaCare). Rather, we need a set of reforms that will each help mightily to fix what is really wrong with the American health-care system: the fact that no one — doctors and patients alike — has any incentive to care what things cost. Because they can be enacted independently, only one ox would be gored at a time and thus only one set of lobbyists would be fighting each reform instead of banding together to fight for the status quo.

A few suggestions:

1) Fix the fee-for-service structure of compensation for hospitals and doctors. When you get paid for every procedure you perform and every test you order, there is, obviously, a big incentive to do more procedures and more tests. But when doctors are on salary, as at Bassett Hospital in upstate New York, costs are much lower. At Bassett, costs are below those of 90 percent of hospitals in New York State, while care is in the top 10 percent nationwide. The famous Mayo and Cleveland clinics are structured the same way. The AMA loves fee-for-service.

2) Fix the malpractice system. The whole system of tort law in this country has been corrupted by a small segment of the American bar while the ABA has stood by and done nothing. (Check out Walter Olson’s www.overlawyered.com.) Huge malpractice-insurance costs are passed on to patients and insurance companies while doctors and hospitals are forced to practice “defensive medicine,” ordering unnecessary tests and procedures to avoid being second-guessed by medically ignorant juries happy to spend other people’s money. Special federal health courts, modeled on bankruptcy courts, would be a big improvement. But nothing would help more than getting rid of the “American rule,” in which each side pays its own court costs regardless of outcome. This creates a heads-I-win-tails-you-lose situation in which the American legal system is used as a means of extortion (“pay us $100,000 to go away or spend a million to successfully defend the lawsuit”). Adopting the so-called English rule (which is actually the rest-of-the-world rule), where the loser pays court costs, would save billions that now go into the pockets of lawyers and expert witnesses for hire. Tort lawyers love the legal status quo.

3) Immunize drug companies from lawsuits if the drug companies have met all FDA requirements (and no fraud is involved, of course). If the FDA fails to do its regulatory job to uncover problems before a drug is licensed, those injured should be compensated from a trust fund funded by a small tax on prescription drugs. Those injured are now compensated by a large tax on prescription drugs disguised as malpractice insurance premiums for drug companies. And a large percentage of the compensation goes to lawyers and expenses, not the victims. Tort lawyers love this one too.

4) Federalize insurance regulation. Insurance is regulated by the 50 states, although we have had national insurance markets for over a hundred years. Having one set of regulations instead of 50 would lower costs dramatically. Requiring insurance companies to offer a defined set of policies, from high-deductible, catastrophic policies designed for those at low risk (such as the healthy young, who make up a large percentage of the uninsured), to medical-savings-account policies, to all-the-bells-and-whistles policies for those older and more affluent. People buying insurance would then be able to compare prices, forcing insurance companies to compete on the basis of price. When there’s price competition, prices go down. State governments and insurance companies will hate this one.

5) Eliminate the deductibility of health-insurance costs for companies and provide tax credits for individuals to buy insurance instead. This was John McCain’s excellent suggestion last year, and Barack Obama shamelessly demagogued it. But making people ask the magic question “How much is this going to cost?” will drain billions out of the cost of insurance. Those used to gold-plated policies at someone else’s expense won’t like this one bit.

6) Incentivize people to watch costs. Safeway, the large supermarket chain, has brought health-care costs under control by making it in the interest of their employees to, once again, ask the magic question “How much will this cost?” while making sure the cost doesn’t bankrupt them if it’s inherently high. Safeway found that the cost of a standard colonoscopy in medical facilities within 30 miles of the corporate headquarters varied from $700 to $7,000. Only in an economic situation where no one cares what things cost is such a disparity possible. Give people a reason to care (such as the use of medical savings accounts) and require facilities to publish prices, and those prices will quickly converge toward the low end of the range. Hospitals and out-patient clinics will oppose this, as will people who have been used to not caring. It is estimated that waste, fraud, legal costs, overcharging, and cost-shifting add about $700 billion a year to the country’s medical costs. If we could eliminate half that, it would be equal to buying every uninsured person in the United States a $7,500-a-year medical insurance policy. And it wouldn’t destroy the most innovative and accessible medical system in the world by turning it over to bureaucrats who don’t care about either patients or costs.

President Obama’s health-care reform appears to be in increasing trouble. The costs, as scored by the Congressional Budget Office, would be horrendous, public support is collapsing, and Congressional Democrats are at each other’s throats over the issue. It appears increasingly unlikely that either house will hold a vote before the August recess, and that recess is likely to be a time when members of Congress will get an earful from the home folks telling them they hate the whole idea.

Congressional Republicans should probably follow Woodrow Wilson’s admirable advice to “never murder a man who is committing suicide.” But once ObamaCare implodes, the loyal opposition will likely be ready with an alternative. I don’t mean an alternative overarching, comprehensive, fix-everything-instantly plan that’s impossible for the layman to get a handle on (that’s what’s wrong with ObamaCare). Rather, we need a set of reforms that will each help mightily to fix what is really wrong with the American health-care system: the fact that no one — doctors and patients alike — has any incentive to care what things cost. Because they can be enacted independently, only one ox would be gored at a time and thus only one set of lobbyists would be fighting each reform instead of banding together to fight for the status quo.

A few suggestions:

1) Fix the fee-for-service structure of compensation for hospitals and doctors. When you get paid for every procedure you perform and every test you order, there is, obviously, a big incentive to do more procedures and more tests. But when doctors are on salary, as at Bassett Hospital in upstate New York, costs are much lower. At Bassett, costs are below those of 90 percent of hospitals in New York State, while care is in the top 10 percent nationwide. The famous Mayo and Cleveland clinics are structured the same way. The AMA loves fee-for-service.

2) Fix the malpractice system. The whole system of tort law in this country has been corrupted by a small segment of the American bar while the ABA has stood by and done nothing. (Check out Walter Olson’s www.overlawyered.com.) Huge malpractice-insurance costs are passed on to patients and insurance companies while doctors and hospitals are forced to practice “defensive medicine,” ordering unnecessary tests and procedures to avoid being second-guessed by medically ignorant juries happy to spend other people’s money. Special federal health courts, modeled on bankruptcy courts, would be a big improvement. But nothing would help more than getting rid of the “American rule,” in which each side pays its own court costs regardless of outcome. This creates a heads-I-win-tails-you-lose situation in which the American legal system is used as a means of extortion (“pay us $100,000 to go away or spend a million to successfully defend the lawsuit”). Adopting the so-called English rule (which is actually the rest-of-the-world rule), where the loser pays court costs, would save billions that now go into the pockets of lawyers and expert witnesses for hire. Tort lawyers love the legal status quo.

3) Immunize drug companies from lawsuits if the drug companies have met all FDA requirements (and no fraud is involved, of course). If the FDA fails to do its regulatory job to uncover problems before a drug is licensed, those injured should be compensated from a trust fund funded by a small tax on prescription drugs. Those injured are now compensated by a large tax on prescription drugs disguised as malpractice insurance premiums for drug companies. And a large percentage of the compensation goes to lawyers and expenses, not the victims. Tort lawyers love this one too.

4) Federalize insurance regulation. Insurance is regulated by the 50 states, although we have had national insurance markets for over a hundred years. Having one set of regulations instead of 50 would lower costs dramatically. Requiring insurance companies to offer a defined set of policies, from high-deductible, catastrophic policies designed for those at low risk (such as the healthy young, who make up a large percentage of the uninsured), to medical-savings-account policies, to all-the-bells-and-whistles policies for those older and more affluent. People buying insurance would then be able to compare prices, forcing insurance companies to compete on the basis of price. When there’s price competition, prices go down. State governments and insurance companies will hate this one.

5) Eliminate the deductibility of health-insurance costs for companies and provide tax credits for individuals to buy insurance instead. This was John McCain’s excellent suggestion last year, and Barack Obama shamelessly demagogued it. But making people ask the magic question “How much is this going to cost?” will drain billions out of the cost of insurance. Those used to gold-plated policies at someone else’s expense won’t like this one bit.

6) Incentivize people to watch costs. Safeway, the large supermarket chain, has brought health-care costs under control by making it in the interest of their employees to, once again, ask the magic question “How much will this cost?” while making sure the cost doesn’t bankrupt them if it’s inherently high. Safeway found that the cost of a standard colonoscopy in medical facilities within 30 miles of the corporate headquarters varied from $700 to $7,000. Only in an economic situation where no one cares what things cost is such a disparity possible. Give people a reason to care (such as the use of medical savings accounts) and require facilities to publish prices, and those prices will quickly converge toward the low end of the range. Hospitals and out-patient clinics will oppose this, as will people who have been used to not caring. It is estimated that waste, fraud, legal costs, overcharging, and cost-shifting add about $700 billion a year to the country’s medical costs. If we could eliminate half that, it would be equal to buying every uninsured person in the United States a $7,500-a-year medical insurance policy. And it wouldn’t destroy the most innovative and accessible medical system in the world by turning it over to bureaucrats who don’t care about either patients or costs.

In his self-serving press appearance on Friday, the president instructed the less enlightened of us that the Gates episode would be a “teachable moment” about race. This, of course, is a favorite and frequent tactic by Obama. Call it the “politics of condescension.” You see, Americans don’t understand race and need to learn about “police brutality” and “race profiling.” (No, there is no evidence either occurred in this case, but we’re teaching here, so the facts don’t matter.) Jewish leaders are told to engage in “self-reflection” about Israeli-U.S. relations. (Yes, they have spent their lives doing so, wrestling with morally agonizing issues, but Obama doesn’t think they’ve gotten it right. So back to school for them.)

The irony is that it was the president who got it wrong. The “teachable moment” might well be utilized by him, not the rest of us. Michael Moynihan reminds us that Cambridge police officer Sergeant James Crowley taught race-profiling classes and was a model officer. Hmm. It seems he’s had plenty of instruction on race. Then there are the specifics of this case:

The undisputed facts of the case are these: Returning from a trip to China, Gates arrived at his Cambridge home to find his front door was jammed. With the help of his driver, he attempted to pry the uncooperative door loose. A passerby observing what appeared to be a break-in in progress (Gates’s house, according to media reports, was recently burgled), alerted the police, and Crowley showed up to investigate. It is at this point that Gates’s and Crowley’s stories diverge, though both agree that, before being arrested, Gates yelled to a gathering crowd of neighbors and police, “Is this how you treat a black man in America?”

According to the police report, Gates reacted in a “loud and tumultuous” manner, justifying his arrest on disorderly conduct. Whether or not it was appropriate to haul Gates to the police station–and a compelling case can be made that loud and boorish behavior, while inadvisable in such situations, shouldn’t be an arrestable offense–is at this point largely irrelevant. Gates isn’t quibbling with what constitutes “disorderly conduct,” but rather maintains that he was “racially profiled” by a “rogue policeman” who “couldn’t stand a black man standing up for his rights.”

None of this has prevented Gates from seizing on the incident to, as Moynihan explains, also insist this is a “teachable moment.” Hmm. The president and Gates seem strangely and perfectly in sync. The purpose of Gates’s directive (and the president’s, we suspect), he told an interviewer, was to make sure we all know that America “is just as classist and just as racist as it was the day before the elections.” Got that?

The teachable moment, then, has nothing to do with this incident. On that score, the president and Gates seem to have fanned the flames, seizing on the encounter to heighten, not diminish racial tensions. This is the sort of teaching Obama delights in. The facts don’t matter much. What is critical is the goal. In this case, that would be to raise the banner of racial victimology.

Other teachable moments, real ones based on the circumstances of this issue, might include the opportunity to think twice before accusing a model officer of racism. (Isn’t that racial stereotyping, to assume a white Boston-area cop was out to hassle the black guy?) It might mean the reminder that the president can’t throw around “stupidly” or other slurs and not be held accountable. And it really might be that if Obama feels beholden to his academic friends and their agenda, he is going to have a hard time maintaining the support of nonminority voters who have had their fill of being “taught” by their liberal “betters.” But I suspect none of those lessons are on Obama’s teaching schedule.

In his self-serving press appearance on Friday, the president instructed the less enlightened of us that the Gates episode would be a “teachable moment” about race. This, of course, is a favorite and frequent tactic by Obama. Call it the “politics of condescension.” You see, Americans don’t understand race and need to learn about “police brutality” and “race profiling.” (No, there is no evidence either occurred in this case, but we’re teaching here, so the facts don’t matter.) Jewish leaders are told to engage in “self-reflection” about Israeli-U.S. relations. (Yes, they have spent their lives doing so, wrestling with morally agonizing issues, but Obama doesn’t think they’ve gotten it right. So back to school for them.)

The irony is that it was the president who got it wrong. The “teachable moment” might well be utilized by him, not the rest of us. Michael Moynihan reminds us that Cambridge police officer Sergeant James Crowley taught race-profiling classes and was a model officer. Hmm. It seems he’s had plenty of instruction on race. Then there are the specifics of this case:

The undisputed facts of the case are these: Returning from a trip to China, Gates arrived at his Cambridge home to find his front door was jammed. With the help of his driver, he attempted to pry the uncooperative door loose. A passerby observing what appeared to be a break-in in progress (Gates’s house, according to media reports, was recently burgled), alerted the police, and Crowley showed up to investigate. It is at this point that Gates’s and Crowley’s stories diverge, though both agree that, before being arrested, Gates yelled to a gathering crowd of neighbors and police, “Is this how you treat a black man in America?”

According to the police report, Gates reacted in a “loud and tumultuous” manner, justifying his arrest on disorderly conduct. Whether or not it was appropriate to haul Gates to the police station–and a compelling case can be made that loud and boorish behavior, while inadvisable in such situations, shouldn’t be an arrestable offense–is at this point largely irrelevant. Gates isn’t quibbling with what constitutes “disorderly conduct,” but rather maintains that he was “racially profiled” by a “rogue policeman” who “couldn’t stand a black man standing up for his rights.”

None of this has prevented Gates from seizing on the incident to, as Moynihan explains, also insist this is a “teachable moment.” Hmm. The president and Gates seem strangely and perfectly in sync. The purpose of Gates’s directive (and the president’s, we suspect), he told an interviewer, was to make sure we all know that America “is just as classist and just as racist as it was the day before the elections.” Got that?

The teachable moment, then, has nothing to do with this incident. On that score, the president and Gates seem to have fanned the flames, seizing on the encounter to heighten, not diminish racial tensions. This is the sort of teaching Obama delights in. The facts don’t matter much. What is critical is the goal. In this case, that would be to raise the banner of racial victimology.

Other teachable moments, real ones based on the circumstances of this issue, might include the opportunity to think twice before accusing a model officer of racism. (Isn’t that racial stereotyping, to assume a white Boston-area cop was out to hassle the black guy?) It might mean the reminder that the president can’t throw around “stupidly” or other slurs and not be held accountable. And it really might be that if Obama feels beholden to his academic friends and their agenda, he is going to have a hard time maintaining the support of nonminority voters who have had their fill of being “taught” by their liberal “betters.” But I suspect none of those lessons are on Obama’s teaching schedule.

After the Ricci ruling, President Obama said that any hiring or school admissions practices based solely on race are unconstitutional, and he condemned the use of quotas. In an interview with the Associated Press, the nation’s first black president stressed that the Supreme Court did not completely “close the door” on affirmative action, if properly structured and in certain circumstances, but he conceded that the court had moved “the ball” away from such efforts. Obama also asserted that affirmative action “hasn’t been as potent a force for racial progress as advocates would claim,” and as consolation, he offered that the best form of affirmative action is a good education for all Americans.

Essentially, Obama delivered a eulogy for affirmative action.

Ah, but if it only were so! Unfortunately, Obama has nominated a passionate defender of racial politics to the Supreme Court. Racial preferences, buried under layers of obtuse rhetoric, are alive and well at elite colleges and universities. Public contracting is rife with racial preferences. Private employers have been cajoled into employing racial preferences under the guise of “diversity.”

A more accurate statement would be that the rationale for affirmative action has disintegrated over time, as has the public’s support for racial preferences and quotas. But there is a virtual industry populated by groups like Sonia Sotomayor’s PRLDEF and the race bully of New Haven, who cajoled the city into dropping the results of its fire fighters’ promotional tests. There are legions of university admissions officers devoted to the cause of “diversity.”

So it will, unfortunately, be some time before affirmative action is buried. Nevertheless, I would agree, happily so, that if the most liberal candidate ever elected to the White House can’t make a full-throated defense of affirmative action, then its days are numbered.

After the Ricci ruling, President Obama said that any hiring or school admissions practices based solely on race are unconstitutional, and he condemned the use of quotas. In an interview with the Associated Press, the nation’s first black president stressed that the Supreme Court did not completely “close the door” on affirmative action, if properly structured and in certain circumstances, but he conceded that the court had moved “the ball” away from such efforts. Obama also asserted that affirmative action “hasn’t been as potent a force for racial progress as advocates would claim,” and as consolation, he offered that the best form of affirmative action is a good education for all Americans.

Essentially, Obama delivered a eulogy for affirmative action.

Ah, but if it only were so! Unfortunately, Obama has nominated a passionate defender of racial politics to the Supreme Court. Racial preferences, buried under layers of obtuse rhetoric, are alive and well at elite colleges and universities. Public contracting is rife with racial preferences. Private employers have been cajoled into employing racial preferences under the guise of “diversity.”

A more accurate statement would be that the rationale for affirmative action has disintegrated over time, as has the public’s support for racial preferences and quotas. But there is a virtual industry populated by groups like Sonia Sotomayor’s PRLDEF and the race bully of New Haven, who cajoled the city into dropping the results of its fire fighters’ promotional tests. There are legions of university admissions officers devoted to the cause of “diversity.”

So it will, unfortunately, be some time before affirmative action is buried. Nevertheless, I would agree, happily so, that if the most liberal candidate ever elected to the White House can’t make a full-throated defense of affirmative action, then its days are numbered.

As Abe nicely captures it, Joe Biden’s advice to Georgians this week is a masterpiece of end-of-life counseling. A “good counselor/bad counselor” dynamic seems to be emerging with the Obama-Biden foreign relations team. Biden’s entourage also performed a key role in a subtle interplay during the Georgia visit, when Russia’s Deputy Foreign Minister, Grigory Karasin, warned third parties against selling arms to Georgia. Karasin invoked a January decree by Medvedev on “measures taken to prohibit the supply of military and double-purpose products to Georgia.” Said Karasin: “The decree foresees the use of special economic measures in relation to nations, international organizations and individuals supplying military equipment to Georgia.” The U.K. Guardianinterprets this as a threat to the United States, but the Moscow Times may be more accurate in emphasizing the threat to Georgia’s regular arms suppliers in Eastern Europe. Either way, the assurance issued yesterday by a senior official traveling with Biden that the U.S. will not be selling arms to Georgia could not have been timed better to evoke appeasement.

Analysis on the arms-sales threat has focused on Russia’s severing military cooperation with Georgia’s patrons. But Moscow may be preparing for something more robust: economic measures against Russia’s trading partners in Eastern Europe, a threat to interdict Caspian Sea gas flowing through Georgia, and possibly a maritime arms embargo on Georgia. Moscow’s recent history with economic pressure includes arm-twisting Ukraine and its E.U. gas customers and cutting off Belarus’s access to Russian markets in order to force political concessions. Russia is redeveloping a Soviet-era naval base in Abkhazia only a few kilometers from the Georgian border: a small but well-placed facility that would allow the Russian navy to control Georgia’s entire coast. A Russian embargo would not have to entail capital warship encounters at sea. Armed patrol craft operating along Georgia’s short coastline would be enough to turn merchant ships away. Georgia has no current arms suppliers who would make more than one attempt to deliver their goods. The pipeline heads on the coast are equally vulnerable.

Russia seems to be preparing for timing as early as August, given Karasin’s references to “provocations” expected from Georgia on the anniversary of last year’s invasion. The main condition Russia needs to implement its provocative measures is inactivity by the U.S. After a series of demonstrations and counterdemonstrations that could have been scripted by Monty Python — a NATO exercise in Georgia in June; Russia’s Kavkaz-2009 shortly thereafter; Obama’s visit to Moscow; Medvedev’s visit to South Ossetia on July 13; the visit of the USS Stout, an Aegis destroyer, to Georgia on July 14 (attended by ostentatious Russian target practice at sea); Biden’s visit to Georgia yesterday — Georgia’s fate will come down to what Putin and Medvedev think they can get away with. Unbearable pressure may be enough, with America’s global end-of-life counselors helping Georgia interpret the writing on the wall.

As Abe nicely captures it, Joe Biden’s advice to Georgians this week is a masterpiece of end-of-life counseling. A “good counselor/bad counselor” dynamic seems to be emerging with the Obama-Biden foreign relations team. Biden’s entourage also performed a key role in a subtle interplay during the Georgia visit, when Russia’s Deputy Foreign Minister, Grigory Karasin, warned third parties against selling arms to Georgia. Karasin invoked a January decree by Medvedev on “measures taken to prohibit the supply of military and double-purpose products to Georgia.” Said Karasin: “The decree foresees the use of special economic measures in relation to nations, international organizations and individuals supplying military equipment to Georgia.” The U.K. Guardianinterprets this as a threat to the United States, but the Moscow Times may be more accurate in emphasizing the threat to Georgia’s regular arms suppliers in Eastern Europe. Either way, the assurance issued yesterday by a senior official traveling with Biden that the U.S. will not be selling arms to Georgia could not have been timed better to evoke appeasement.

Analysis on the arms-sales threat has focused on Russia’s severing military cooperation with Georgia’s patrons. But Moscow may be preparing for something more robust: economic measures against Russia’s trading partners in Eastern Europe, a threat to interdict Caspian Sea gas flowing through Georgia, and possibly a maritime arms embargo on Georgia. Moscow’s recent history with economic pressure includes arm-twisting Ukraine and its E.U. gas customers and cutting off Belarus’s access to Russian markets in order to force political concessions. Russia is redeveloping a Soviet-era naval base in Abkhazia only a few kilometers from the Georgian border: a small but well-placed facility that would allow the Russian navy to control Georgia’s entire coast. A Russian embargo would not have to entail capital warship encounters at sea. Armed patrol craft operating along Georgia’s short coastline would be enough to turn merchant ships away. Georgia has no current arms suppliers who would make more than one attempt to deliver their goods. The pipeline heads on the coast are equally vulnerable.

Russia seems to be preparing for timing as early as August, given Karasin’s references to “provocations” expected from Georgia on the anniversary of last year’s invasion. The main condition Russia needs to implement its provocative measures is inactivity by the U.S. After a series of demonstrations and counterdemonstrations that could have been scripted by Monty Python — a NATO exercise in Georgia in June; Russia’s Kavkaz-2009 shortly thereafter; Obama’s visit to Moscow; Medvedev’s visit to South Ossetia on July 13; the visit of the USS Stout, an Aegis destroyer, to Georgia on July 14 (attended by ostentatious Russian target practice at sea); Biden’s visit to Georgia yesterday — Georgia’s fate will come down to what Putin and Medvedev think they can get away with. Unbearable pressure may be enough, with America’s global end-of-life counselors helping Georgia interpret the writing on the wall.

It seems that Obama has been spectacularly unsuccessful in rallying his own party, let alone the country as a whole. The Washington Postrecaps:

House Democrats feuded openly over health care Friday before shaking hands on a deal that guaranteed only that they would keep negotiating, wrapping up a week in which consensus on a sweeping overhaul of the nation’s health-care system seemed to diminish by the day.

White House aides announced a week ago that President Obama was ready to “take the baton” for his biggest domestic campaign initiative, and indeed Obama campaigned for his proposals virtually nonstop this week, including taking an hour of prime-time television to make his case directly to the American public.

But despite the president’s attentions, Congress was further away Friday from passing health-care legislation than it was on Monday, with only days left before lawmakers leave Washington for their August recess.

The White House and its dutiful spinners on cable TV and in the blogosphere claim it’s the mean Republicans throwing sand in the gears of health-care reform. But it’s plain to see for all but the still-smitten Obamaphiles: health care has stalled because the president hasn’t made the sale to the American people, and Democrats aren’t willing to walk the plank for a government takeover of a sixth of the economy.

Once the August “deadline” comes and goes, lawmakers can venture out into their districts. They will have plenty of explaining to do. The midyear budget review will readjust the deficit, no doubt upward. Unemployment will unfortunately rise. The president’s poll numbers will drift down. And the public’s skepticism over the president and Congress, which spends and taxes with no end in sight, will only increase, especially if they insist on pushing a trillion-dollar health-care plan.

Liberals are convinced that a vast network of grassroots activists stands ready to carry Obama over the health-care finish line. Perhaps. But they haven’t stopped the hemorrhaging of support for the president and his policies. Before Obama gets around to convincing the public to embrace his government-run health-care vision, he’ll need to get his own party on board. And he’s a long way from doing that.

It seems that Obama has been spectacularly unsuccessful in rallying his own party, let alone the country as a whole. The Washington Postrecaps:

House Democrats feuded openly over health care Friday before shaking hands on a deal that guaranteed only that they would keep negotiating, wrapping up a week in which consensus on a sweeping overhaul of the nation’s health-care system seemed to diminish by the day.

White House aides announced a week ago that President Obama was ready to “take the baton” for his biggest domestic campaign initiative, and indeed Obama campaigned for his proposals virtually nonstop this week, including taking an hour of prime-time television to make his case directly to the American public.

But despite the president’s attentions, Congress was further away Friday from passing health-care legislation than it was on Monday, with only days left before lawmakers leave Washington for their August recess.

The White House and its dutiful spinners on cable TV and in the blogosphere claim it’s the mean Republicans throwing sand in the gears of health-care reform. But it’s plain to see for all but the still-smitten Obamaphiles: health care has stalled because the president hasn’t made the sale to the American people, and Democrats aren’t willing to walk the plank for a government takeover of a sixth of the economy.

Once the August “deadline” comes and goes, lawmakers can venture out into their districts. They will have plenty of explaining to do. The midyear budget review will readjust the deficit, no doubt upward. Unemployment will unfortunately rise. The president’s poll numbers will drift down. And the public’s skepticism over the president and Congress, which spends and taxes with no end in sight, will only increase, especially if they insist on pushing a trillion-dollar health-care plan.

Liberals are convinced that a vast network of grassroots activists stands ready to carry Obama over the health-care finish line. Perhaps. But they haven’t stopped the hemorrhaging of support for the president and his policies. Before Obama gets around to convincing the public to embrace his government-run health-care vision, he’ll need to get his own party on board. And he’s a long way from doing that.

Fred Barnes thinks Americans have figured out what’s up and that the ObamaCare battle is lost. Looking at the poll numbers, he concludes: “1) The public is smarter than we think. They know their health care. 2) A bill that’s rejected this soundly has little chance of being enacted, and the congressional recess won’t make things better. 3) Obama is not persuasive. He’s been touting his plan for months as support for it dropped. He’s lost the argument.” Well, now we’ll see what can be passed. It might not be anything. The status quo never looked so good.

If this doesn’t scare you, it should: “If President Obama has his way, another such unelected authority will be created — a manager and monitor for the vast and expensive American health-care system. As part of his health-reform effort, he is seeking to launch the Independent Medicare Advisory Council, or IMAC, a bland title for a body that could become as much an arbiter of medicine as the Fed is of the economy or the Supreme Court of the law.”

The New York Timeswarns Obama that he’s overexposed: “The all-Obama, all-the-time carpet bombing of the news media represents a strategy by a White House seeking to deploy its most effective asset in service of its goals, none more critical now than health care legislation. But longtime Washington hands warn that saturation coverage can diminish the power of his voice and lose public attention.” Part of the problem is that when he’s out there, he’s not saying much.

ABC News calls it health-care chaos: “Just a day after Speaker of the House Nancy Pelosi said there is ‘no question’ she has the votes to pass health care, it looks now like Democrats in the House have also given up on having a health care vote by the August recess.”

On again, off again: “Hours after calling their chairman a liar, Blue Dogs on the Energy and Commerce Committee stood by that chairman’s side and announced together that the once-collapsed health-care negotiations are back on track.”

Meanwhile, from the “meddling in democracies” file: “Let’s hope the Administration was paying attention to India’s environment minister when he told Mrs. Clinton a thing or two about climate policy Sunday. ‘There is simply no case for the pressure that we, who have among the lowest emissions per capita, face to actually reduce emissions,’ Jairam Ramesh told Mrs. Clinton in a closed-door meeting, according to a copy of his remarks distributed after the session. ‘And as if this pressure was not enough, we also face the threat of carbon tariffs on our exports to countries such as yours.’ ”

Did Obama actually apologize for his “stupidly” uninformed comments about the Gates-Crowley incident? Maybe in private. How nontransparent if so.

In Virginia: “The Obama administration dispatched a senior aide to Richmond Wednesday to urge former Virginia Gov. L. Douglas Wilder to get behind state Sen. Creigh Deeds, the Democratic gubernatorial nominee. . . . But Wilder, in disclosing the meeting in an interview with POLITICO, made it clear that he remained far from endorsing Deeds and was in no hurry to weigh in on the closely watched race — all the while outlining with his typical brutal candor what he thought some of the party’s challenges were and what was at stake. On what the former governor called ‘bread-and-butter issues,’ he said of Deeds: ‘Tell me what the man has done? I haven’t heard it.'” Ouch.

In New Jersey, you knew this was coming: “One day after federal authorities arrested five New Jersey politicians involved in a massive money-laundering operation, GOP gubernatorial candidate Chris Christie hit the airwaves with his first general election ad reminding voters of his record fighting corruption. . . . Christie’s law-and-order background has always been his strongest asset, and the mass arrests (which led from an investigation that he initiated as U.S. attorney) couldn’t come at a better time. It also comes on the same week he tapped a female county sheriff as his running mate.”

The Obama administration says it is defending democracy and the rule of law in Honduras. “But in fact, a close look at Mr. Zelaya’s time in office reveals a strongly antidemocratic streak. He placed himself in a growing cadre of elected Latin presidents who have tried to stay in power past their designated time to carry out a populist-leftist agenda. These leaders, led by Venezuela’s Hugo Chávez, have used the region’s historic poverty and inequality to gain support from the poor, but created deep divisions in their societies by concentrating power in their own hands and increasing government control over the economy, media and other sectors.”

Fred Barnes thinks Americans have figured out what’s up and that the ObamaCare battle is lost. Looking at the poll numbers, he concludes: “1) The public is smarter than we think. They know their health care. 2) A bill that’s rejected this soundly has little chance of being enacted, and the congressional recess won’t make things better. 3) Obama is not persuasive. He’s been touting his plan for months as support for it dropped. He’s lost the argument.” Well, now we’ll see what can be passed. It might not be anything. The status quo never looked so good.

If this doesn’t scare you, it should: “If President Obama has his way, another such unelected authority will be created — a manager and monitor for the vast and expensive American health-care system. As part of his health-reform effort, he is seeking to launch the Independent Medicare Advisory Council, or IMAC, a bland title for a body that could become as much an arbiter of medicine as the Fed is of the economy or the Supreme Court of the law.”

The New York Timeswarns Obama that he’s overexposed: “The all-Obama, all-the-time carpet bombing of the news media represents a strategy by a White House seeking to deploy its most effective asset in service of its goals, none more critical now than health care legislation. But longtime Washington hands warn that saturation coverage can diminish the power of his voice and lose public attention.” Part of the problem is that when he’s out there, he’s not saying much.

ABC News calls it health-care chaos: “Just a day after Speaker of the House Nancy Pelosi said there is ‘no question’ she has the votes to pass health care, it looks now like Democrats in the House have also given up on having a health care vote by the August recess.”

On again, off again: “Hours after calling their chairman a liar, Blue Dogs on the Energy and Commerce Committee stood by that chairman’s side and announced together that the once-collapsed health-care negotiations are back on track.”

Meanwhile, from the “meddling in democracies” file: “Let’s hope the Administration was paying attention to India’s environment minister when he told Mrs. Clinton a thing or two about climate policy Sunday. ‘There is simply no case for the pressure that we, who have among the lowest emissions per capita, face to actually reduce emissions,’ Jairam Ramesh told Mrs. Clinton in a closed-door meeting, according to a copy of his remarks distributed after the session. ‘And as if this pressure was not enough, we also face the threat of carbon tariffs on our exports to countries such as yours.’ ”

Did Obama actually apologize for his “stupidly” uninformed comments about the Gates-Crowley incident? Maybe in private. How nontransparent if so.

In Virginia: “The Obama administration dispatched a senior aide to Richmond Wednesday to urge former Virginia Gov. L. Douglas Wilder to get behind state Sen. Creigh Deeds, the Democratic gubernatorial nominee. . . . But Wilder, in disclosing the meeting in an interview with POLITICO, made it clear that he remained far from endorsing Deeds and was in no hurry to weigh in on the closely watched race — all the while outlining with his typical brutal candor what he thought some of the party’s challenges were and what was at stake. On what the former governor called ‘bread-and-butter issues,’ he said of Deeds: ‘Tell me what the man has done? I haven’t heard it.'” Ouch.

In New Jersey, you knew this was coming: “One day after federal authorities arrested five New Jersey politicians involved in a massive money-laundering operation, GOP gubernatorial candidate Chris Christie hit the airwaves with his first general election ad reminding voters of his record fighting corruption. . . . Christie’s law-and-order background has always been his strongest asset, and the mass arrests (which led from an investigation that he initiated as U.S. attorney) couldn’t come at a better time. It also comes on the same week he tapped a female county sheriff as his running mate.”

The Obama administration says it is defending democracy and the rule of law in Honduras. “But in fact, a close look at Mr. Zelaya’s time in office reveals a strongly antidemocratic streak. He placed himself in a growing cadre of elected Latin presidents who have tried to stay in power past their designated time to carry out a populist-leftist agenda. These leaders, led by Venezuela’s Hugo Chávez, have used the region’s historic poverty and inequality to gain support from the poor, but created deep divisions in their societies by concentrating power in their own hands and increasing government control over the economy, media and other sectors.”